Here be Swine Flu

It was today reported in the 'ouse of Commons, by none less than the Health Secretary, that there have been twenty-five (25) possible cases of swine flu in the UK since the start of the scare.

One such occurred in my hospital this weekend. Basically, it was total bollocks - the woman in question came in with a straightforward pneumonia, but because she was eight months pregnant the medical team looking after her shipped her on to the obstetricians, on the basis that she was doing reasonably well and at that stage in a pregnancy the priority if she went off would obviously be getting her baby delivered.

As far as I can make out, the obstetricians spent the entire weekend trying to convince the poor lady that she would die and that if she didn't she'd need to be put on a ventilator for them to deliver the baby. In amongst all this they realised that she'd been to Mexico and so called the local Health Protection Agency about her querying swine flu. The only problem, of course, was that she got back more than two months ago - not really consistent with the incubation period - and had a far, far more likely diagnosis already in place.

In the end the weekend team took her away from the panicky obstetricians and put her back on a medical ward, where she is doing just fine, and it looks like despite the hullabaloo that the baby will not be born with a pig's head this time. I wonder how many more of the 25 cases were utter bollocks...?

Saints preserve us....

God bless Jade Goody for what she's done for screening.

But a musical of her life? Spare us that, please - spare me the pound signs in Clifford's weaselly eyes... I feel nauseous just thinking about it.

Occupationals hazards 02, or why ignorance is bliss

Urgh. Today was an 11-hour day (do not believe the government bullshit about the European Working Time Directive - it is code for not paying us for working out of hours), and it ended with my having to aspirate the drain from a pancreatic pseudocyst.

In English, this means attaching a big syringe to a piece of plastic tubing which had been passed through someone's abdominal wall and into the pseudocyst, then left there so that any gunk that built up there would come out through it. A pancreatic pseudocyst, again hopefully in English, is a big collection of the aforementioned gunk which forms near the pancreas, normally after a nasty bout of inflammation of the pancreas.

The patient in question is a charming lady who'd been in and out with this problem for months and months, and was waiting to see the specialists to see if she could have it chopped out (not always a good idea). It was meant to be being flushed regularly, but this was very rarely recorded by our desperately overworked nursing staff and I suspect not done as often as it should be.

On my way to do the procedure, I checked her results, then got my plastic apron and gloves on and got to work. The thing was normally stiff to start with thanks to all the clotted muck in there, and on this occasion it was particularly bad - so I gave an extra syringe-heave...and with awful predictability, the syringe basically exploded, leaving me spattered in stuff the colour and texture of runny dog poo. And smell - god, the smell.

Worst of all, I knew it wasn't poo: it was group C streptococcus sensitive only to clindamicin.

I envied the patient her ignorance.

Occupational hazards 01, or why being a doctor is not comparable to being a banker

Recently, my registrar and I were doing a ward round at quarter to eight on a tuesday morning and discovered that one of our patients had been complaining of bleeding from the "back passage". While in your average man in the street this inspires nothing more sinister than a snigger at the euphemism, to pretty much every doctor in the land it inspires at best a weary shudder.

Obviously, this is because blood in someone's poo means you have to stick your finger up their arse. In medical parlance this is to "perform a PR", and the chances are you'll find something which stinks even worse than usual thanks to the disgusting smell partly-digested blood produces. Unfortunately for us, it's a really good clinical examination - you find out if they're constipated, if there's obvious blood, if it's likely to come from low down the gut or higher up, whether there are any lumps or bumps suggesting anything from haemorrhoids to cancer, you can feel the prostate in men, and you can use it to localise abdominal pain by applying pressure in various different directions which can, for instance, help you identify an appendicitis.

It's also not something you particularly want to do at the best of times: only the dangerously weird actually enjoy it - but before you've had breakfast on a tuesday morning adds that little bit of top-up misery.

Our patient, thankfully, was fine. As we went to wash our hands I shot the reg a mournful look. He replied simply, "Sometimes I envy those city boys." We carried on.